Attachment D.13 VA Suicide Prevention Safety Plan and Suicide Behavior and Overdose Report - SBOR.pdf
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- Q201--NEW Dyersburg CBOC Services
- Solicitation number
- 36C24925R0056
About this file
This document is a Department of Veterans Affairs (VA) internal guidance document detailing staff-specific requirements for creating Suicide Prevention Safety Plans and Suicide Behavior and Overdose Reports (SBOR). The document provides a comprehensive table specifying which healthcare professional roles (such as MD/DO, Licensed Psychologists, Clinical Social Workers, Registered Nurses, and others) are authorized to develop safety plans and complete SBORs based on their credentials, facility scope of practice, and competency.
Key stipulations include that safety plans are brief clinical interventions collaboratively developed between a patient and provider during or before a suicidal crisis, and SBORs collect information on suicidal behaviors and non-suicidal overdoses resulting in adverse events. The guidance explicitly notes that certain roles like Licensed Practical Nurses, Peer Support Specialists, Unlicensed Assistive Personnel, Psychological Technicians, and Vocational Rehabilitation Specialists are not permitted to complete these documents. Additionally, trainees in authorized roles may complete steps marked "Yes" with an appropriate co-signer, and disciplines not specifically identified in the table are prohibited from creating safety plans or SBORs.
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Text version
FOR VA INTERNAL USE ONLY 08/17/2022
v2
Department of Veterans Affairs (VA) Suicide Prevention Safety Plan and Suicide Behavior and Overdose Report (SBOR) Templates
Staff Specific Guidance
A Suicide Prevention Safety Plan is a brief clinical intervention, collaboratively developed between a patient and a provider, for use during or before a suicidal crisis. VHA staff members can develop a safety plan with a patient if:
1. There is a “Yes” next to the staff member’s credentials in the table below; AND
2. The local facility Chief of Staff concurs with this determination; AND
3. Safety planning is within facility scope of practice and/or competency.
Suicide Behavior and Overdose Reports (SBOR) collect information on suicidal behaviors and non-suicidal overdoses that result in an adverse event. VHA staff members can complete an SBOR if:
1. There is a “Yes” next to the staff member’s credentials in the table below; AND
2. Completion of the SBOR is within facility scope of practice and/or competency.
SBOR SP Safety Plan MD/DO1 Yes Yes Licensed Psychologist (PhD/PsyD)2 Yes Yes Clinical Pharmacist Practitioner Yes Yes LCSW/LMSW/LISW3 Yes Yes LMFT4 Yes Yes LPMHC5 Yes Yes Addiction Therapist Yes Yes LPN6 No No RN7 Yes Yes APRN: NP/CNS8 Yes Yes PA9 Yes Yes Peer Support Specialist No No UAP10 No No Psychological Technician, Social Work Assistant
No No
Vocational Rehabilitation Specialist No No Rehabilitation Counselor Yes Yes
1Medical Doctor/Doctor of Osteopathic Medicine; 2Doctor of Philosophy/Doctor of Psychology; 3Licensed Clinical Social Worker/Licensed Master of Social Work/Licensed Independent Social Worker; 4Licensed Marriage and Family Therapist; 5Licensed Professional Mental Health Counselor; 6Licensed Practical Nurse; 7Registered Nurse;
8Advanced Practice Registered Nurse: Nurse Practitioner/Clinical Nurse Specialist; 9Physician’s Assistant;
10Unlicensed Assistive Personnel, including Health Tech, Medical Assistant, and Nursing Assistant.
Note: A trainee in ANY of these categories may complete each step marked with a “Yes” with an appropriate co-signer.
If a particular discipline is not identified in the table above, the discipline may not complete the Safety Plan or the
SBOR.
File details come from the government source that posted it. Updated .